23825 HIGHWAY 99.PDF11111111 lill 11
14075
23825 HIGHWAY 99
ET DA-iE'
CITY OF EDMONDS
BOARD OF ADJUSTMENT
APPLICATION FOR VARIANCE
t0rrHQUt!S7_t0A.)3:C,AL.0
,eip
FEE
RECT # 2,-?,9�
APO'S
HEARING DATE:
APPLICANT -Mr. Art Furbush ADDRESS 18304 Corliss North
CITY & ZIP Seattle, Washinqton
PHONE 365-7339
INDICATE TYPE OR DEGREE OF INTEREST IN PROPERTY Owner of Bldg-.. & tot
LOCATION OR ADDRESS OF PROPERTY 23825 - U.S. 99 North Edmonds, Wa. 98020
LEGAL DESCRIPTION OF PROPERTY As attached
VARIANCE REQUESTED: To remodel existing nonconforming structure & add to
Bldg. as per submitted plan & remodel existing front entry.
FOR OFFICE USE ONLY
USE ZONE: C G
ZONING ORDINANCE REQUIREMENT: 40' Set back from streets ,
STATE OF WASHINGTON) ss.
COUNTY OF SNOHOMISH)
51gliature 'o"V*icdnt,OAer, or
Representative �1�
On this date, before me, the undersigned, a Notary Public in' an' oretheState
of Washington, duly Commissioned and sworn, personally appeared
who, being duly sworn, on his/her oath deposes and says that -W—hhe has repared
and read the attached statements and has -acknowledged to me that the recititations
contained therein are true, and has signed this instrument as his/her free and
voluntary act and deed for the purposes therein Tgntioned
Subscribed and sworn to before me this,_-;�,�Z-day 19
� , I
Notary Public in and for the State of Washington
it Y k-
DUANE BERENTSON
Secretary
STATE OF WASHINGTON
CITY 0F.EDMOND.S
DEPARTMENT OF TRANSPORTATION
Office of District Administrator * D-1, 6437 Corson Ave. So., C-81410 9 Seattle, Washington 98708
Bruce G. Finke
Associate City Planner
250 Fifth Avenue North
Edmonds, Washington 98020
Dear Mr. Finke:
February 3, 1986
SIR 99 MP 43.88
Northwest Motor Inn
Determination of Non -Significance
Local File # ADB-2-86
This Department has completed its review of your Determination of Non -
Significance for the Northwest Motor Inn proposal. We have concluded that the
following concerns need to be addressed before the project progresses:
1. Having looked at the right-of-way plans it is apparent that the city limits
and the eastern right-of-way of SR 99 are coincedent. This makes SR 99
part of Snohomish County, thus the developer will need to apply to the
WSDOT District Utilities Engineer to obtain an access permit. For further
information regarding the permit please contact:
Paul Johnson P. E., District Utilities Engineqr
Washington State Department of Transportation
6431 Corson Avenue South, Box C-81410
Seattle, Washington 98108
2. WSDOT and Snohomish County have formulated a route continuity plan for
SIR 99. In compliance with this plan the following improvements will be
required from the developer:
-a. Construction of a cement concrete curb, gutter and 5 foot wide
sidewalk along the property's entire SR 99 frontage. The front face
of the curb should be located 42.5 feet from the highway centerline.
(SR 99 cross section is attached for your information.)
b. To tie in the new curb and gutter line with the existing road surface,
it will be necessary to widen the roadway. The pavement should be
saw cut at the existing edge stripe (the fog line) and the shoulder
replaced with full depth pavement to the new gutter.
C. It will be necessary to modify the drainage system to remove the
water collected by the new access and gutter.
February 3, 1986
Mr. Bruce Finke
Re: Northwest Motor Inn
Page 2
d. Disturbed conduit and junction boxes for detection loops and
luminaires must be replaced. This should also be coordinated with
the Utilities Engineer.
3. The Department of Transportation is preparing to upgrade the existing
signal at 238th Street S.W. Our project is scheduled for ad in spring 1987.
Close coordination between the developer and the Department of
Transportation will be required to avoid potential conflicts.
4. The legal description contains more land than is proposed for use by the
motel. What is being done with the remainder of the property shown as a
"restaurant site"? If all the land in the parcel is to be developed, frontage
improvements will be needed along SR 99 from the intersection of SR 99
and 238th Street S.W. to southerly property line of the motel site.
5. This department would prefer that the motel have only one driveway, not
the two that are proposed.
6. The number of vehicle trips generated per day should be calculated from
values given in the ITE Trip 6eneration Manual Ord Edition), under Land
Use Code 320. We estimate that a total of 286 vehicle trips per day
(instead of 56-60) would be generated -by an assumed 60 percent occupancy.
Of these 286, 18 trips would occur during peak hour.
Thank you for the opportunity to comment on this proposal. If you have any
questions, please call Elise Ching (764-4171) of the Traffic Division or Dave
Oberg (233-2406) or Vern Swing (233-2409) of my staff.
Sincerely,
Richard F. JOH ON, P.E.
District Design Engineer
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cc Oberg/Developer
E. Ching/Traffic
K. Lanfear/Utilities
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APPLICATION
ThO City of Edmonds for
SIDE SEWER PERMff
OUTSIDE INSIDE 0 REPAIRS 0
OWNER ..... ......... /
......................... ....... I ............................ .........
HOUSE No . ........ &;iL�'� - /t/ w',l -,- � 7
............................ I ............. I .............. .....................
:213 COD
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............... CONTRACTOR .......... / ...........
- - - — ------------ ................ ..... .... PERM7 �No
...... ......... PERMIT No.
STREET
............. AVENUE LOT No . .........
.............................. ............... ............... 11�09K No.. ....... R/
........... .............
............... ......
NAME ADD .... ;'//*a
.. �<� ... . . ...............
.. ... .......... /
Date
BACKFILL WORK ORDER ISSUED ............................................ DEPOSIT, $ ................. ..................
SEWER WORK ORDER ISSUED .................................. _ ....
Approved:
DATE.
.... BY . . ...
-P 10
CITY of EDMONDS BUSINESS LICENSE APPLI&TION
Civic Center - Edmonds, Washington 98020 DATE LICENSE NO.
City Clerk Phone 775-2525
4STRUCTIONS:
All items must be com�leted
or application will not be ac-
cepted.
Sign and return application
with fee. Renewals received
after February 15 must pay
penalty in addition to fee.
NEW BUSINESSES AFTER
JULY 31, 1/2 FEE.
TYPE OF BUSINESS ANNUALFEE AFTER FEB. 15
U a " ", �L I .
-ASS
I YEAR
LIC. EFFEC. DATE
REASG. LIC. NO
'PE�'j
[] (A) HOME OCCUPATION
le, a
I I I I I I
I . I I I
El (B) BUSINESSWITH
1 TO 3 EMPLOYEES
RECEIPT NO
DATE PAID
AL_
PRINT 'X'
IN SPEC. BOX
4 (C) BUSINESSWITH
101(
0 00j2
FOR ISSUE OF
CORRECTED
4 TO 9 EMPLOY EES
El (D) BUSINESS WITH 10
FEEPAID
_ _
PENALTY,PAID
212�01 .1
LICENSE WITH
OR MORE EMPLOYEEc
I
1 I_
'LC' ACTION.
$15.00 $ 22.50
$20.00
$ 30.00
$22.00
$ 33.00
$75.00
$112.50
:15( NEW APPLICATION (LA)
0 RENEWAL (L B)
0 CHANGE (LC)
(PLEASE MAKE ANY NECESSARY CHANGES) 11 DELET ECEIVEQD)
NAME OF FIRM BUSINESS PHONE NO. OF EMPLOYEES
MYKUT REAL ESTATE SCHOOL 11 775-6645 1 J U�_ 2 0 1982
MAILING ADDRESS NATURE OF BUSINESfDMONDS FIRE DEPT.
23825 HWY 99, EDMONDS WA, 98020 Rf*e_tlls�
I S&,qVjC-6
BUSINESS ADDRESS INDIVIDUAL PARTNERSHIP CORPORATION
S A N r n^lpr�_
F_x___1 (S) (P) (C)
OWNERS NAME HOME ADDRESS
-PARRft BRADSHAW 9025 JUANITA DRIVE. N,E. KIRKLAND WA. 98033
HOMEPHONE DATE OF BIRTH PLACE OF BIRTH SOCIAL SECURITY NUMBER
488-1747 1 5/24/34 � SEATTLE WASHINGTON 1 533-32-6955
EMERGENCY NOTIFICATION (1) NAME & TELEPHONE =11�r I HUMPSON G .3bl
(PLEASE LIST TWO) (2) NAME&TELEPHONE 44�LUCAS J�. 1565-
WASHINGTON STATE TAX NO..C6OO 056 438 2 APPLICANT'S SIGNATURE ' VXL-LL�Vl
DO NOT WRITE BELOW THIS LINE
STAFF REVIEW: FILL IN LAND USE CODE, UFIR NUMBERS, ZONING, ETC. CHECK APPRC PPROVAL, DATE, AND
SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT" SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT DAT LAND USE CODE ZONING CODE
eq, APPROVE 0 DISAPPROVE SIGNATURE
CONDITIONAL USE PERMIT
COMMENTS
BUI DING DEPARTMENT
>A
DATE - Iq
C PP ROVE 0 DISAPPROVE
SIGNATURE 14, 12- W_
Building 0
Permit 0
Hotel/Motel
Apt. Bldg.
W
(A)
M I I 1 0
Office Bldg.
(0)
COMMENTS:
Occupancy 0
Restaurant
(R)
Group 0
Hosp/Nurs Home
(H)
CAPACITY: (NO. UNITS, APTS. OFFICES, SEATS, BEDS, STUDENTS)
E3
School
(S)
FIRE DEPARTMENT
DAT
U. F. 1. R.
APPROVE 0 DISAPPROVE
SIGNATURE 19
To- F 010 EIE
COMMENTS:
POPOE DEPARTMENT
DATE _7'224'Z
_,Rr—APPROVE 0 DISAPPROVE
SIGN ATURE
COMMENTS:
PUP�dC WORKS DEPARTMENT
IXAPPROVE 0 DISAPPROVE
DATE72-SIGNATURE
COMMENTS:
PLEASE RETURN TO CITY CLERK
DECLARATIONS OF APPLICANT
Please answer all questions
1. What are the physical characteristics, (i.e. topography, shape
of lot, etc.) which create a hardship for you in regard to
development of your property?
Physical location of existing structure
2. How does your property differ from other property in the same
vicinity?
Needs updating old & worn
3. Will this variance be detrimental to the public or damaging to
other property or improvements in the vicinity?
None whatsoever
4. What hardships will result to you if the variance is not granted?
Will these hardships have been caused by your own action?
In order for a restaurant (existing use) to be feasible as
opposed to marginal a certain amount of square footage is req-
uired. We wish this square footage- also bldg is substandard code wise,
this will be corrected.
5. Can you make reasonable use of your property without the variance?
Extremely difficult.
YX
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240 TH
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6 6
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LICENSE NO.
0 6b, 1 a
Civic Center - Edmonds, Washington 98025W O�N r�
CITY of EDMONDS BUSIJWS LICENSE APPLIC'ATION
DATE
6_11,e )r_�
j,.' '— TYPEOFBUSINESS ANNUAL FEE
City Clerk Phone 775-2525 T
&6'
INSTRUCTIONS:
• All items must be completed
or application will not be ac-
cepted.
• Sign and return application
with fee. Renewals received
after February 15 must pay
penalty in addition to fee.
NEW BUSINESSES AFTER
0. SPEC.
(A) HOME OCCUPATION
$15.00
SINESSWITH
$
1 TO 3 EMPLOYEES
BOX
(c) BUSINESSWITH
$22.00
JE OF
4 TO 9 EMPLOYEES
C T E D n
(D) BUSINESSWITH10
$75.00
WITH
M.
OR MORE EMPLOYEES
AFTER FEB. 15
IN NEWAI-FLIUAIIUN (LA)
0 RENEWAL (LB)
0 CHANGE (LC)
JULY 31, 112 FEE. (PLEASE MAKE ANY NECESSARY CHANGES) 0 DELETE (L D)
NAME OF FIRM BUSINESS PHONE NO. OF EMPLOYEES
4S jo L/
7/-0. �e ;;P
MAILING ADDRESS NATURE OF BUSINESS
L 19
$ 22.50
S 30.00
$ 33.00
$112.50
BUSINESS ADDRESS
INDIVIDUAL
PARTNERSHIP
CORPORATION
OWNERS NAME
HOME ADDRESS
a4?Vq A, x
HOMEPHONE
DATE OF BIRTH
PLACE OF BIR TH
SOCIAL SECURITY NUMBER
EMERGENCY NOTIFICATION (1) NAME &TELEPHONE L/,(/
(PLEASE LIST TWO) (2) NAME & TELEPHONE
WASHINGTON STATE TAX NO. APPLICANT'S SIGNATURE
DO NOT WRITE BELOW THIS LINE
STAFF REVIEW: FILL IN LAND USE CODE, LIFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR DISAPPROVAL, DATE, AND
SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT" SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT DATE 1O.Y142 LAND USE CODE ZONING CODE
APPROVE 0 DISAPPROVE a - '741 9
SIGNATURE
CONDITIONAL USE PERMIT
COMMENTS F77171
BUILDING DEPARTMENT -1,
DATE fO I'h 1 13
2�-'APPROVE 0 DISAPPROVE SIGNATURE
Building
Permit
0
0
Hotel/Motel
Apt. Bldg.
(L)
(A)
El
Office Bldg.
(0)
COMMENTS:
Occupancy
El
Restaurant
(R)
Group
El
Hosp/Nurs Home
(H)
CAPACITY: (NO. UNITS, APTS. OFFICES, SEATS, BEDS, STUDENTS)
.
El
School
(S)
FIRE DEPARTMENT DATE /0 - 212 - 92-
'X APPROVE 0 DISAPPROVE SIGNATURE :;,i �1— a —
COMMENTS:
e volyn Qz*,rV1*.f
101-9firal
PO4eE DEPARTMENT DATE / . .. I
t�"APPROVE 0 DISAPPROVE SIGNATURE
COMMENTS: 6
PUBLIC WORKS DEPARTMENT
0 APPROVE 0 DISAPPROVE
DATE 74-'
SIGNATURE
COMMENTS:
DI =A_Q_C-7 1a1:T110K1[ TfN ntTV ni CDV
DATE FILE # AM —51-9>q
CITY OF EDMONDS �,ITE PL�AN SIGN EXHIBITS
IMILDING ELEVATIONS
APPLICATION FUR k_aMND�APE N V--�ENVIRONMENT DATA
FEE RECT #
ARCHITECTURAL DESIGN BOARD
PLAN MODIFICATIOtTO-FILE #
Do not use pencil on this form. HEARING DATE- G 7 1 Ra
& # � 0 4,4 -1-5ta"q-
I / L. PHONE
OWNER/REPRESENTATIVEJY&l Tt Oil a I fllt)p�,tlrteA 6)Y12.
I
ADDRESS / (� _)_ 0 0 - /,( z:- . / _�)-
4?_ (/ 0- V it e_
ZIP CODE V,11-
J
ARCHITECT/DESIGNER L--_V,�(J4V-0 PHONE 4_�_4-06�'O
ADDRESS "12— _A__ZIP CODE 290e9�-
PROPERTY ADDRESS ZONING
LEGAL DESCRIPTION
PLANS SUBMITTED FOR APPROVAL:
1. Building Plans
2. Sign Elevations
1(
Preliminary V , Final -Site Plan L11
Landscape Plan L7 -Elevations -
V -Site P�an Landscape Plan t__"'
APPROXIMATE DATE WORK WILL BEGIN ON PROJECT 149IL2=1 . L�_(rl
V
ESTIMATED TIME FOR COMPLETION OF WORK 1'y e nt4t.7)'&
RELEASE/HOLD HARMLESS AGREEMENTS: The undersigned applicant, his heirs and assigns, in
consideration for the City processingthe application agrees to release, indemnify, defend and
hold the City of Edmonds harmless tftq 4ny and all damages and/or claims for damages,
including reasonable attorney fees-ii-iarising from any action or inaction of the City whenever
such action or inaction is basea4n'whole or in part upon,false, misleading or incomplete
information furnishe8 by the applicant, his agents or employees.
PERMISSION TO ENTER SUBJECT PROPERTY: The undersigned applicant grants his, her or its
permission for public officials and —the staff of the City of Edmonds to enter the subject
property for the purpose of inspection and posting attendant to this application.
APPADBI/PFORMS (Sign re V Ap icant)
ADB Application
Page 3
t 00 00
C I T Y 0 F E D M 0 N D S
S E P T I C T A N K A P P R 0 V A L
TO WHMM IT MAY CONCERN:
This is to certify that the septic tank— for
has been inspected and.are according to City of Edmonds standards
DATE: --
Inspected by:
APPLICATION CARD No . ......................................
for
The City of Edmonds SIDE SEWER PERNaT
OUTSIDE E] INSIDE E] REPAIRS EASEMENT No . ......................... ............
- ,*. / () ICE gig
OWNER..................................................................................................................... CONTRACTOR .............................................................................. ..................... PERMIT No . .........................
2-7,9 F? STREET
HOUSENo . .............. .......................................................... ............ - AVENUE LOT No . ...................................................................... BLOCK No . ...............................................
0cNAME ADD . .........................................................................................................................................................
0
Date
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
SEWER WORK ORDER ISSUED .......................... ............... DATE ---
'64"1. , '9,9
1, Y,
................................. By ...................................................................
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September 26, 1989
TO: Permit Coordinator, Building Divisi6rr':.
FROM: Dan Smith, Engineering Inspector
ADDRESS 2�
OWNER
PLAN CHECK #
After review of the subject building permit application, we have the
following comments:
1. Construction hours are: WEEKDAYS ........... 7:00 a.m. to 10:00 p.m.
WEEKENDS/HOLIDAYS..10:00 a.m. to 6:00 p.m.
2. A Right -of -Way Construction Permit is required for any work on
City property.
3. Connection to City water system required. Fees paid.
4. Connection to City sanitary sewer system required; obtain separate
permit. Fees paid.
5. Water and sewer lines to be separated by 10 foot minimum.
6. Driveway must be paved a minimum of 20 feet back from City
right-of-way; separate permit required.
7. Driveway slope not to exceed 14%.
8. Back water valve required if downstairs plumbing is below
elevation of upstream manhole.
9. Builder/Owner responsible for containing all temporary runoff and
erosion control on site. Construction may not impact neighboring
properties in any way.
10. No burning of construction refuse without approval from Fire Dept.
11. Street to be kept clean of debris, dirt, mud, and construction
materials. Contractor responsible for dust control.
12. Inspection required on drainage system, catch basin installation,
driveways, and sidewalks. A final engineering inspection is
required prior to the building division granting occupancy.
13. Repair or replace all defective existing curb, gutter, and
sidewalk. If intersection is involved, installation of wheelchair
access may be required.
N. (Al //� , l*,�("e,(-�-e
;-A.(if, i- R/ TXTFORMS
E
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PACIFIC WATER WORKS SUPPLY CO., INC.
2900 FIRST AVE. SOUTH SEATTLE, WASH. 98134 RECEiVED
BACICFI'LO'W':�P.'R'EV'E'NTIFhN,,�'DEWCE TEST AND MAINTENANCE REPORT m rt 71
FILE NO.
FIRM NAME MO/21VO e-d "Z' Al Al
ADDRESS 2 3 -9 -0 1,14 2 5/ CITY Cee&�'� 44"4 ZlPqJ-0--20 PHONE NO. -7
PARTY CONTACTED If Iq 72 REDUCED PRESSURE BACKFLOW DEVICE 1:1
DOUBLE DETECTOR CHECK
DOUBLE CHECK VALVE ASSEMBLY El
PRESSURE VACUUM BREAKER El
MAKE OF DEVICE MODEL SERIAL NO.W-2:-, �X SIZE
BY-PASS
DATEINSTALLED METER NO. METER READING
LINE PRESSURE PSI PRESSURE DROP ACROSS FIRST CHECK VALVE __ PSI
L06ATION OF DEVICE _rS_e4f>'7
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DIFFERENTIAL
CHECK VALVE NO.
1
CHECK VALVE NO.
2
PRESSURE RELIEF VALVE*
TEST
BEFORE
REPAIRS
LEAKED
LEAKED
OPENED AT -PSI
CLOSED.TIGHT
CLOSED TIGHT
REDUCED PRESSURE
PART CLEAN
REPLACE
PART CLEAN
REPLACE
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REPLACE
NEW
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REMARKS:
TEST
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CLOSED TIGHT
E]
OPENED AT
PSI
AFTER
REDUCED PRESSURE
REPAIRS
L
*REQUIRl5-eONLY ON REDUCED PRESSURE BACWFLOW DEVIC AlLf
RETURN REPORT TO: Azndot gol -9-9 'eF
TESTED BY Zn2 DATE
PACIFIC
VVIATIER REPAIRED BY DATE
FINAL TEST BY DATE
V 119 ISU P I Y C KOIN�C
Serving the Water Works Industry Since 1917 TESTER'S WASHINGTON STATE CERTIFICATION NO.
WHITE -CUSTOMER PINK -OFFICE CANARY -REPORT FILE
PACIFIC WATER WORKS SUPPLY CO., INC.
2900 FIRST AVE. SOUTH - SEATTLE, WASH. 98134
BACKFILOW PREVENTION DEVICE TEST AND MAINTENANCE REPORT
FILE NO.
F I R M N A M E -.'V If' .17 Al Al
I
-9 -5- Y Y2c7- CITY
ADDRESS, ZIP'� T'040 PHONE NO. 7_71- 3520 W
PARTY CONTACTED UL e-6 IV!-i REDUCED PRESSURE'BACKFLOW DEVICE 0
DOUBLE DETECTOR CHECK
DOUBLE CHECK VALVE ASSEMBLY El'
PRESSURE VACUUM BREAKER
MAKE OF DEVICE LA-,1Lkr5t4_S MODEL SERIAL NO. SIZE
BY-PASS
DATEINSTALLED METER NO. METER REA DING
LINE PRESSURE PSI_ PRESSURE DROP ACROSS FIRST CH,ECK VALVE fSI
1. , :. I - f
q 'I
LOCATION OF DEVICE
CHECK VALVE NO. 1
CHECK VALVE NO. 2
DIFFERENTIAL
TEST
PRESSURE RELIEF VALVE'
BEFORE
REPAIRS
LEAKED El
LEAKED
11
OPENED AT
PSI
CLOSED TIGHT'%, J4
CLOSED TIGHT
REDUCED PRESSURE
PART CLEAN REPLACE
'PART CLEAN
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NEW
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1:1
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REMARKS:
11 T
TEST
CLOSED TIGHT El
CLOSED TIGHT
El
OPENED AT
PSI
AFTER
REDUCED PRESSURE
REPAIRS
*REQUIRED -ONLY ON REDUCED PRESSURE BACKJ=LOW DEVICE
RETURN REPORT TO: Aamzdjak / 0 - 8,9 / 0 1
MCIFIC
MIATER
V119
Serving the Water Works Indusity Since 1917
TESTED BY DATE
REPAIRED BY
FINAL TEST BY
TESTER'S WASHINGTON STATE CERTIFICATION NO.
DATE
DATE
WHITE -CUSTOMER PINK -OFFICE CANARY -REPORT FILE
PACIFIC WATER WORKS S UPPLY CO., INC.
2900 FIRST AVE. SOUTH * SEATTLE, WASH. 98134
BACKFILOW PREVENTION DEVICE TEST AND MAINTENANCE REPORT
FILE NO
FIRM NAME t,)
ADDRESS 91 CITY PZ20/\laS'LA4 ZIPT90" PHONEr NO.. -7-71-'F-0
PARTY CONTACTED REDUCED PRESSURE BACKFLOW DEVICE El
.DOUBLE DETECTOR CHECK El
DOUBLE CHECK VALVE ASSEMBLY �9
PRESSURE VACUUM BREAKER El
MAKE OF DEVICE 0 MODEL P C SERIAL " N Otj_ 7X 72 SIZE
BY-PASS
DATE INSTALLED METER NO. METER READING
LINE PRESSURE,, 5.,'ZI— PSIk
LOCATION OF DEVICE
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CHECK VALVE NO.
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TEST
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BEFORE
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LEAKED
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CLOSED TIGHf
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RED UCED PRESSURE
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REMARKS:
TEST
CLOSED TIGHT
El
CLOSED TIGHT
El
OPENED AT
AFTER
—PSI
REDUCED PRESSURE
REPAIRS
*REQUIREb;-ONLY ON REDUCED PRESS=LOW DEVIV
j000fl.
RETI /RAI REPORT TO:
PACIFIC
WATER
V119
Serving the Water Works Industry Since 1917
TESTED BY DATE
REPAIRED BY
FINAL TEST BY
TESTER'S WASHINGTON STATE CERTIFICATION NO.
DATE
DATE
WHITE -CUSTOMER PINK -OFFICE CANARY -REPORT FILE
.:dl
00
CD
V)
VC
CITY of EDM ON DS SIM SEWER P E,,R' M T
For Inspection Call 771-3202 r-- P n PERMIT NO. 0 9 1� 09 : 02,
S � a - � L �` J" E
Address of Construction: /;e V ?
Property Legal Description (Include all easements):
Owner and/or Builder:
Contractor & License No: Lnck Lic-C. 1 7 L 1��
VIA CALUNGER
Singl:e Family Residence LIFT STATION
Mul ti - Fami ly
(No.
of
Units
Commercial
(No.
of
fixture Units
Invasion into Cit� Right -of -Way: No Yes �< (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No Yes
(If Yes, easement
required,
attach legal
description and county easement
number.)
THE
ITEMS LISTED ON THE BACK
RECEIVED
I certify that
I have read and sh�ll c
DEC 15
Date
with the items
listed on the back.
1989
PUBLIC WORKS
Permit Fee: 30-00 Issued By:
A900. 00 I.Date Issued: F9
Trunk Charge: 12 =Lf-L
Assessment Fee: Receipt No.:
Pd .1pen-
Partial Inspection:
Comments Date Initial
Final Inspection Approved:
Date initial
Rejected:
Reason —Ta t _e Initial
** PERMIT MUST BE POSTED ON JOB SITE **
Wh.ite Copy - File Green Copy -"Inspector Buff Copy - Applicant
,The City of Edmonds Side Sewer Drawing EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION 'REPAIRS F� LID NO - ------------------ - ASMT. NO - -----------------
OWNER------------------------------------------------ -----------------------------------------------
JOB ADDRESS ------- CONTRACTOR ....... I ................ PERMIT NO.
.... ......
---------------------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------
NAMEOF ADDITION .............. -------------------------------------------- -------------------------------------- -----------
F VIA BALLINGER
0 s, S TIO
LIFT ST�ATION
I
L
L-�
-E7
e'lVV.c, -c,(o
W Decr.
PWW-000 I - 11175 (R EV. 11/78)
I le I ;
9�', P-Vt,
3'—
V Af
Approved: V Aa V 0 Vx" V-[-u V
Let 0,660,
3_qo
DATE(� ---------------------------------I
010
0 PLANNING DATA
0 1
New Commercial I Multi -Family Projects
Name. -
Date:
Site Address:
Plan Check #: BLD -
2".Me- O�j LAS_-e.�l Ax---� CIOCNve-A -eez, No
Pro ect Description: I
I rr-c�r� r-', 4 eo.,,erese-, ec-V r'o�,
1-1 "Inn— -- L_ __,
Use(s) Proposed:
Allowe W6se: N
nn!T
CUP File Number: NIA
To Allow What Uses: NIN
Legal Nonconforming Land Use Determination Issued: (YES AO
Reduced Site Plan Provided: (YES /0-
Zoning: C(;-
Map Page:
Comp Plan Designation:
Corner Lot: (YES
Flag Lot: (YES
AD8 File Number (date waived): NIA
LotArea: NO
Plans Match ADB Approved: (YES / NO)
Shoreline Required: (Y
Critical Areas Determination #:NVA
Study Required
Waiver
SEPA Determination:
XExempt
El Needed (for sites with 500 cubic yards of grading or within 200 feet of Puget Sound or Lake
Ballinger. Requires: (1) Fee, (2) Environmental Checklist, and (3) APO List with notarized form).
Setbacks
Street:
Side:
Rear:
Actual Setbacks
Street:
Side:
Side:
Rear:
Lot Coverage/FAR Required:
Lot Coverage/FAR Provided:
Lot Coverage/FAR Calculations:
Building Heligh t
Datum Point:
Datum Elevation:
Maximum Height:
Actual Height:
Subdivision:
Lot Aggregation Required:
'Landscaping
Landscaping Matches ADB Approved:
��Landscaping Bid Provided: (YES I NO)
Bond Amount (100% Bid):
90,
Plan Review
40010
0 PLANNING DATA 0 - =FILE
New Commercial I Multi -Family Projects
Commerciat
Business Name
Type/Use
Parking
Ratio
Tenant
Area
Required
Parking
Oex-
C-Ocrv%s
-7
Total Parking Required.
Total Parking Pro vlded-
117:7
Nuffi-Famil
_�'PorkingA
# Bedrooms per Dwelling Unit
Parking Ratio
Units
Required
Parking
Studio
1.21D.U.
I Bedroom
1.5/D.U.
2 Bedrooms
3 + Bedrooms
2.0/D.U.
Total Parking Required --
Total Parking Provided.
e, oJ� LI-2-Se- dc;,e--=, r1ok
19
Plan Review By:
4 CITY OF EDMONDS
APPLICATION
to the
��ITECTURAL DESIGN BOARD
12/78
DATE 15) 79 FILE # Ab8_%_?q
SITE PLAN
BUILDING PLANS (3): ELEVATIONS
LANDSCAPE PL�---
TP4�E__
ENVIRONMENTAL DATA 14—Receipt #
SIGN EXHIBITS MC7'�-
PLAN MODIFICATIONS� TO"FILE NUMBER:
HEARING DATE
OWNER/ REPRESENTATIVE ZOA)7-Rf44�)T- D6RSjf-;A_1 VAAr/D, —PHONE - 3�23-850(0
ADDRESS &O-2—IR t�' 4UG: FEFAST- ZIP CODE CZ
CONTACT PERSON Skip 2)jQ(L)"106 PHONE
ADDRESS � - 1 A 13 ouc� —ZIP CODE.
ARCH ITECT(�ES IGNER)_6aLILEaCT���(�
��PHONE
PROPERTY ADDRESS IA� CL)Al� ZONING CC,
LEGAL DESCRIPTION A5 EC-Q ArMCWf;:T�)
PLANS SUBMITTED FOR APPROVAL:
1. Building Plans — Preliminar Final
Site Plan Landscape Plan kl"� Elevations
2. Sign Elevations_____L,��Site Plan Landscape Plan
3. Modification of previous approval
EXISTING USE OF PROPERTY___J?E�5
DESCRIPTION OF PROPOSAL ALT-GQ_ Ac, jzqsT7jt)r2Ak)-r
Megan
APPROXIMATE DATE WORK WILL BEGIN ON PROJECT 3o
ESTIMATED T124E FOR COMPLETION*OF WORK rp(o -160 D4ys
I (we) hereby certify to the best of my (our) knowledge, that the statements and
information contained herein are, I
to" T R E ii-"I" FILE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
MAILING AULIHhbb
�J41_00
CITY,.
(5)uj, A.
TD—DRESS
13TR N
lilFLrPHONE NUMBER
L9
NAME
ADDRESS
�ELEPHONE NUMBER
STATE LICENSE NUMBER
Legal Descnptlor�_Of �Iroperty include all easements
(show below or attach two copies)
ZONEr
JOB 111611ff19Y 7C0
ADDRESS 2302S frf I 'I
I'
LEGAL DERRIPTIO!N HE K $VISION NO. LID NO.
7C
T ESC,
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. APPROVED BY
R EOU IRED DEDICATo N
EXISTING REOUIRED DEDICATION
PROPOSED—f"----
RIGHT OF WAY CONSTRUCTION PERMIT RECUIRED
STREET USE PERMIT REOUIRED. A
SEE ENGINEERING MEMO DATED
qnl�
1 REMARKS
NEW
RESIDENTIAL PLUMBING
ADDIALTER
f9l
L&J COMMERCIAL
MECHANICAL
REPAIR
SIGN
DEMOLISH
EXCAVATE
OR FILL
FENCE
(_ x _FT)
REMODEL
IM
F
WOOD STOVE/ RETAINING WALL/
INSERT ROCKERY
RENEWAL
. NUMBER OF STORIE NUMBER OF
DWELLING
UNITS
7ATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
0
z
LU
z
a
z
Uj
4ETER SIZE
BUILDING SUPPLY
FIXTURE UNIT
W
A16
AR
SIGN AREA
ALLOWED PROPOSED
ENV. REVIEW ADB NO.
OMPLETE EXEMPT
c 1-57
-r7o
L
ORELI E#
SH L
b,---
0 E E�
' A
tq
U
�ARIANCE OR CU
#SH
PL NNING REVIEW By
LIF
DATE
SETBACKS — FEET
HEIGH
LOT V RAG E
z
A- z
FRONTL5 SIDE REAR
4,
CL
REMARKS
CHECKED BY
TYPE OF CONSTRUCTION
CODE
119400
HEIGHT
SPECIAL INSPECTOR
AREA 1��
OCCUPAN CY
GROUP
OCCUPANT
LOAD
EOUIRED
R U
YES NO
n � Y
REMARKS
z
PROGRESS INSPECTIONS PERUBC 305
Lffi"AuAJ 7;WJJ.1 ooFv xy4v.,, L*wzy-rm6y, 6ve
2- .
—
PLAN CHECK FEE
F I Rv
BUILDING
A L I PL_U
PLUMBING
�,Wj,f I A,
6- A bAjAj0 5 C
MECHANICAL
This Permit covers worK to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curL-s, sidewelks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
ENERGY CODE
Permit Limit: 1 Year - Provided Worl� is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
in n, its officials,
oui the City of Edmonds, Washingto
harmless
, employees, and agents from any and all claims for damages of
20
a: whatever nature, arising directly or indirectly from the issuance
<
x issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
of this permit.
modify, waive or reduce any requirement of any city ordinance
0 nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT UE
provision."
I hereby acknowledge that I have read this application; that the
ATTENTION
information given is correct; and that I am the owner, or the duly
a uthorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
will be employed in viola tion of the Labor
AUTHORIZES
ONLY THE
ed thereby, no person
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
tion Insurance. DATE SIGNED
SIGN TURE fOWNE OR AGENT
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
771-3202
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.
UBC
r14AVTF:P .1
I
VALUATION I FEE
_Z031k,
APPLICATION APPROVAL
This application is not a permit until
signed by the Building official or his
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
OFFICIAL*S SIGNATURE DATE
RELEASED BY:
DATE
ORIGINAL — File YELLOW — Inspector L
PINK — owner GOLD — Assessor
2v to I
Lj
514
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AUG 2 4"79
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PLANNING DEPT.
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